DESCRIPTION: This is a proposal from the UNMC to expand the teaching of EOM for medical students, residents and pulmonary fellows. It is a resubmission with some changes from the last grant cycle. The candidate proposes to organize a coordinating group with broad expertise to facilitate the changes in the curriculum. Specific content about occupational carpal tunnel, low back pain, asthma and other occupational pulmonary diseases will be added as clinical correlation in existing courses. An opportunity for summer research supported by stipends will be added between the freshman and sophomore years. Occupational history taking will be added to the Integrated Clinical Experience (ICE) course along with a worksite visit and material on prevention of environmental/occupational illness. Content will be added to problem based learning (PBL) exercises in the sophomore year. A Rural Health Day will be spotlighted at the beginning of the sophomore year, with a variety of environmental health topics featured. Appropriate EOM content will be added to all the cores which comprise the second year curriculum and again as juniors. Students at UNMC take an objective structured clinical exam (OSCE) at the end of their second year and an environmental aspect of the case will be added to each OSCE. Some content will be added to senior electives in a number of specialty areas, as well as in basic science. A workbook of case based materials will also be developed to be used both by senior students and by house officers. In addition, computer assisted learning modules will be developed.